Xenogeneic collagen matrix versus free gingival graft for augmenting keratinized mucosa around posterior mandibular implants: a randomized clinical trial

Clin Oral Investig. 2023 May;27(5):1953-1964. doi: 10.1007/s00784-022-04853-8. Epub 2023 Jan 13.

Abstract

Objectives: To assess the clinical efficacy of xenogeneic collagen matrix (XCM) plus apically positioned flap (APF) in augmenting the keratinized mucosa (KM) width (KMW) and thickness (KMT) around posterior mandibular implants and compare it with free gingival graft (FGG) plus APF.

Material and methods: Thirty patients with KMW ≤ 2 mm in the posterior mandibular implant site were randomly allocated to the FGG group (FGG plus APF) or the XCM group (XCM plus APF). Clinical assessments, including KMW and KMT, shrinkage rate of established KM, and peri-implant soft tissue health, were evaluated during a 6-month follow-up. Additionally, the esthetic outcomes and patient-reported postoperative morbidity were investigated.

Results: At 6 months, the KMW measured 3.60 ± 0.79 mm in the FGG group and 3.28 ± 0.96 mm in the XCM group (p = 0.186). Both groups showed a tendency for graft contraction (FGG, 42.11%; XCM, 53.22%). The KMT measured 1.24 ± 0.34 mm in the FGG group and 0.95 ± 0.29 mm in the XCM group, with statistical difference (p = 0.002). No difference in the peri-implant soft tissue health was observed between the two groups (p > 0.05), but the esthetic outcomes were better in the XCM group (p < 0.05).

Conclusions: XCM plus APF rendered a similar clinical efficacy in augmenting KMW as that with FGG plus APF, but with higher shrinkage. XCM plus APF was inferior with respect to FGG plus APF in augmenting KMT. The esthetic outcomes were better with XCM plus APF than FGG plus APF. Clinical relevance XCM plus APF graft was inferior with respect to FGG plus APF in augmenting KMT.

Trial registration: Trial registration number: ChiCTR2200058027 and date: 03/27/2022.

Keywords: Free gingival graft; Keratinized mucosa; Randomized controlled trial; Xenogeneic collagen matrix.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Collagen / therapeutic use
  • Connective Tissue / transplantation
  • Dental Implants*
  • Esthetics, Dental
  • Gingiva / transplantation
  • Gingivoplasty* / methods
  • Humans
  • Mucous Membrane

Substances

  • Dental Implants
  • Collagen